VOL. 8, NO . 6

P.O. Box 982 Evanston, Illinois 60204

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IN THIS ISSUE:

Treating Hypertension Without Drugs

Q A

Weight loss

Dr. Robert Mendelsohn

In my Newsletter l as t month, I d is c u ssed the definition of hype rt e n s i o n. This mo nth' s News l e t ter is devo t ed to non-dru g tr ea t ments fo r this symptom .

Is it possible to control high blood pressure through dieting , rather than by taking antihypertensive drugs?--M.U.

Since you have given me no specific figures about how high your blood pressure is, I can only answer you in general terms. Nondrug management of hypertension certainly is safer and often is more effective than drug management, and it should almost always be seriously attemp ted as the first line of defense. As a matter of fact, except in the rare cases of malignant hypertension (which may be an acute medical emergency), drug therapy should be the last resort.

In a six-year-old article entitled "Weight and Blood Pressure: Findings in Hyper t ension Screening of One Million Americans " (Journal of the Ameri­can Medical Association, October 6, 1978), Dr. Jeremiah Stamler et al report that weight loss is effective in reducing blood pressure in a sizable number of obese hyper tensive patients . The investigators report, "With safe methods of weight control, i . e., better long-term nutritional and exercise habits, an important advance might be achieved in the control of hypertension."

IVith every extra pound of weight a person gains, there is a corres­ponding increase in blood volume, and the heart must work that much harder to pump more blood through a more extensive circulatory system. I am not in favor of crash diets. What I do consider important is not a quick loss of weight, but rather a basic change in eating habits, with attention not only to the quality and quantity of the food itself, but also to the social circumstances surrounding each meal. Meals eaten under tranquil cir­cums tances with friends are less tension-producing than a quick, stand-up meal eaten alone .

Q

A Nutritional

approaches

In another six-year-old study printed in the New England Journal of Medicine (January, 1978), Dr. Efraim Reisin of Tel Aviv Medical School reported on research he did using simple weight control with no restric­tion on salt intake to control blood pressure. The Israeli study involved 24 hypertensive patients who were placed on a diet without drugs as well as 57 who were put on a diet and were given antihypertensive medications, but in doses considered too low to control their blood pressure. Each patient lost at least six pounds, and the average weight loss was 21.5 pounds. After this weight loss, blood pressure returned to normal for 75 per cent of those in the first group and 61 per cent in the second group. The control of blood pressure occurred in both sexes, all age groups, and in moderately-obese as well as in very obese patients. Not only did the group without drugs do better, but an accompanying Journal editorial said the results vJere "remarkable," and weight control may be a potent tool for lowering blood pressure.

Somehow, it all sounds to me as though the hypertension fi ghters are just re-inventing the wheel!

I had been taking Inderal for hypertension for close to three years, but I developed various symptoms which, after reading your columns, I recog­nized as side effects of the drug. I have discontinued using Inderal, and I just read in your column your question, "Have you tried the time­tested methods of controlling blood pressure, such as nutritional approaches, which physicians used successfully years ago?"

Can you please tell me what these nutritional approaches are? --M. B.

There are many theories about which foods to avoid or eliminate altogether in lowering blood pressure, but there is general agreement that heavy use of salt, refined sugar, caffeine and meat with a large fat componen t all are associated with hypertension. Decreasing the intake of these sub­stances is important in the lowering of blood pressure.

In a 1976 report of the Tufts Medical School a lumni, Dr. Lot Page, a Tufts University heart specialist, stated that salt is the single greates t cause of high blood pressure. (What would you expect from a doctor whose first name is Lot?) Dr. Page recommends using less than a quarter of a teaspoon of it a day, and he adds that salt has been identified as the single grea test cause of high blood pressure by a Harvard University study of tribal group s in the Solomon Islands.

That study, which contained an analysis of all the factors medically associated with blood pressure, showed that the highest blood pressures were suffered by the tribal group which consumed the most sal t. Page said that of 18 societies in which hypertension is completely absent, all are low-salt populations, and this is true "whether they live in the desert, jungle or Arctic."

I would also suggest tha t you investigate other substances that may be influential in lowering blood pressure, such as vitamins C and E, onions and garlic. These substances are cited and explained in "The Prac­tical Encyclopedia of Natural Healing" by Mark Bricklin (Rodale Press, $12.95). Bricklin cites such interesting experiments as the one conducted in 1948 by a doctor a t the University of Geneva whose test group of about 100 hypertensive patients found relief through gar lic. This do ctor claims the herb lowered his patients' blood pressure by dilating the blood ves­sels, which relieved symptoms such as angina, dizziness and headaches.

Dr. Richard A. Ahrens of the University of Maryland believes that sugar plays a major role in hypertension. Writing in the March 1975 issue of the American Journal of Clinical Nutrition, Dr. Ahrens points out, "The reason that I remain convinced that sucrose raises blood pressure is because we have been able to r a ise blood pressure at vJill in our laboratory by providing supplemental sucrose to both experimental r a ts and human volunteers." 2

Q A

Macrobiotic diet

Q

A

Q

Another way to lower blood pressure is through use of such tech­niques as biofeedback, yoga and transcendental meditation. These may benefit you greatly if your hypertension is related to pressures and anxiety caused by your work which you may not be in a position to change.

Other avenues of investigation include philosophic systems such as macrobiotics, which integrates specific nutritional patterns into a uni­versal lifestyle. According to Michio Kushi, author of "The Book of Macrobiotics" (Japan Publications, $7 .95), the macrobiotic way of eating is based on native common sense along with the "intuitive understanding of the relation between man and his environment." Kushi says the problem of calories, carbohydrates, protein, fat, vitamins, minerals and acid and alkaline substances must be understood from a modern scientific viewpoint in connection with the macrobiotic way of eating in order to have proper knowledge.

I hope these suggestions serve as a reference point for you and other readers who have been asking me the same question.

In a recent question on hypertension, one of your readers wrote that she has controlled her blood pressure by means of a macrobiotic diet. Would you please explain what this diet consists of?--Mr s. H.N.

Information on macrobiotics and macrobiotic diet may be obtained from the following three references:

1) "The Book of Hacrobiotics: The Universal Way of Health and Happi ­ness," by Michio Kushi (Japan Publications, Inc., distributed by Japan Publications Trading Co., 200 Clearbrook Rd., Elmsford, N.Y . 10523, $7.95)

2) "The Hacrobiotic Way of Healing," by Michio Kushi (East-West Publications, 359 Boylston, Boston, Mass . 02116, $9.95).

3) "An Introduction to Hacrobiotic Cooking," by Wendy Esko (East­West Publications, 359 Boylston, Boston, Hass. 02116).

My doctor told me to go off salt for my high blood pressure. Since you so often disagree with doctors' opinions, what's your opinion of this kind of diet?--H. To

John H. Laragh, M.D., Professor of Hedicine and director of the cardio­vascular center and the hypertension center at New York Hospital-Cornell Medical Center reported in the Journal of the American Medical Associa­tion (December 10, 1982) strong evidence that a low-sodium diet will lower blood pressure in "perhaps" one-third of the hypertensive population.

In that same issue of JAMA, David A. HcCarron, M.D., director of the hypertension program at the Oregon Health Sciences University, Portland, warned that dietary restrictions of sodium could result in a concomitant reduction in calcium intake (as well as other essential nutrients) which may cause even higher blood pressure.

Perhaps you and your doctor can discuss these articles.

I am 68 years old, have high blood pressure, and am on a salt-free diet. How bad are sodium nitrite, monosodium glutamate, and sodium phos­

phate for a man with my medical history? ~1ost foods on the market today contain one or the other of these preservatives. --E.G.

3

A Avoiding

chemicals

Q

A Positive

mental attitude

Q

Your salt-free diet is fairly standard management for high blood pressure. However, your letter fails to mention whether you are taking any medica­tion, and there are plenty of interactions between many of the common foods and prescribed drugs.

A large dietary intake of sucrose tends to decrease sexual activity, and this effect may be accentuated if drugs like aspirin and phenacetin are also taken ("Hazards of Medication," by Eric Martin, M.D., Lippincott). Ingestion of large amounts of sucrose with phenacetin, aspirin and caffeine compound may inhibit growth . Beer, Chianti wine, cheddar and other strong cheeses, and pickled herring may be lethal when taken with some antihyper­tensives including Eutonyl and with some antidepressants. Licorice may complicate treatment in cardiac patients, therefore patients on antihyper­tensives, diuretics and other cardiovascular drugs should beware of con­suming large quantities of licorice.

Even vit amins may lead to problems. Thus, Vitamin B Complex may cause hemorrhage if given with anticoagulants. Large doses of Vitamin C may potentiate the action of barbiturates and salicylates by interfering with their excretion . In general , the toxicity of drugs may be increased by die ts which contain high concentrations of certain carbohydrates, rancid fats and oils; very high concentrations or inadequate amounts of protein; high concentra tions of s al t, and inadequate amounts of certain vitamins.

While this list does not inc lude the particular chemicals you referred to, I have always adv ised my patients, and people in general, to avo id the common foo d additives and preservatives insofar as possible. You are correc t in stating that these substances are present in most foods avail­able today , but a good doctor or nutritionist should be able to help you find your way to chemically uncontaminated foods.

For the second time, we a r e spending the winter in Tucson. In the East, where we live during the res t of the year, my blood pressure readings average 140/86, but here in Arizona the readings are 122/72. I have been taking Hydropres for hypertension for four years .

I don't change my diet or exercise pattern very much when we come out here. But I am much happier. I enjoy the restaurants, the shopping areas, the people milling around. Back East, we live in the country, away from everything and everyone. As far as I'm concerned, it's a depressed a rea .

Might my mental a ttitude influence my blood pressure read ings?--R.M.

Your letter is eloquent testimony that mental atti tude makes all the diff erence in blood pressure values. Given the data contained in your letter, I can ' t think of a better interpretation than the one you have made.

For years, I have been extremely hypertensive. My systolic pressure hovers between 200 and 230 with a diastolic pressure ranging from the high 90's to 120. Pretty bad, huh? I've been on medication since I was in my 30's, and I am now 54 .

My doctor spent years switching me from Hydrodiuril to Inderal and back again. Two years ago, I hemorrhaged for three weeks, was weak from loss of blood and had no appet ite. I was not admi tted t o a hospital . Instead, I was sent home with a prescription for a blood coagulant and was told to "make sure" I took my blood pressure medications. I did as the doctor ordered, but I developed ano ther problem---potassium depletion. I was rushed to the hospital in shock.

A doctor who specializes in hypertension was called in to care for me, and I have been go ing to him ever since. For two years, I've been on the following medications (I hope you're ready for this!): Apresoline,

4

A Hypnosis

Q

A Nota

bad decade

Inderal, Diuril, Slow K plus assorted vitamins and minerals. Within the two years I've been going to this doctor, my pressure has

fallen as low as 145/75, but it is more often on the high side. I am a secretary in the Intensive Care Unit at Children's Hospital and have my pressure read a t least once a week.

I'm writing to you in desperation because I'm just about ready to give up on the pills. But I'm scared of what will happen if I do give them up. My personal life has been very stressful: I've been married to a compulsive gambler for 33 years, and that is enough to give anyone high blood pressure. I finally am getting a divorce, and I feel I've improved somewhat because of this decision.

What is your opinion on hypnosis for hypertension?--M.K.

I would dearly love to present your case to medical students throughout the country as a classic example of 1) the haste of doctors to prescribe drugs; 2) the dangers, including potassium depletion, of those drugs; 3) the ability of patients to survive not only their disease (in your case hypertension) but even more impressive, to survive their treatment over two decades; 4) the difficulty of breaking the drug habit, and 5) the ability , even after many years, to solve one 's pathology through changes in lifestyle (although I don't really know which is more stressful --being married to a compulsive gambler or working as a secretary in a children ' s hospital's intensive care unit).

Several years ago, I served as medical advisor to a six-part tele­vision series on alternative health systems which was presented by the Chicago affiliate of NBC. One of the participants, psychiatrist Bennett Braun, M.D., discussed his successful use of hypnotherapy for hypertension and a variety of other conditions.

I'm sorry it's taken you 20 years to seek out this valuable alterna­tive to drug therapy, and I wish you all possible success in discovering more about this side-effects-free pa thway to health.

I have been reading with interest of your campaigns against compulsory immunizations and various drugs and medical procedures, and I sympathize with you for the amount of discouragement you get. Undoubtedly this is the same struggle against reason that met Galilee when the Church forced him to retract his theory that the Ear th was not the center of the universe.

The majority of the human race seems to suffer from xenophobia, my own dear father being a prime example. When he's advised against using salt, sugar, foods rich in cholesterol, food additives, etc., he sloughs off tha t advice with, "That's what I've been eating for 60 years, and it hasn't killed me yet." He then has to take four kinds of pills to keep his blood pressure down and to keep his heart from attacking, all the while assuming this is just the natural consequence of old age .

This seems to be the thinking of the majority, a t least the majority of the people I know, most of whom consider me a "nut" for thinking other­wise. How do you keep from becoming discouraged, and how do you deal with those who refuse to accept human reason and science as the source of truth and a means of improving the physical and social environment?--C.N.

Why should I be discouraged when our side is winning? Just look at the victories over the last few years: The American Medical Association has abandoned the routine annual physical examination; the American Cancer Society has abandoned the routine annual Pap smear; the American College of Radiology has abandoned the routine annual chest x-ray; the American Academy of Pediatrics has abandoned the routine annual tuberculin skin test and even has come out in favor of breastfeeding, and the Physicians' Desk Reference, whose distribution once was limited to physicians, now 5

Q

A Informing

patient on stress test risks

appears on the bestsellers' list. More than two-thirds of mothers now are breastfeeding their newborns, and the percentage of home births climbs every year. During the past year, the media has effectively educated the American public about the risks of infant immunizations, and just a few weeks ago, the National Institutes of Health warned every pregnant woman to beware of her obstetrician's recommendation of the use of ultrasound. The Supreme Court of the Province of Ontario, Canada, recently ruled in favor of a mother and father who rejected mandatory silver nitrate/anti­biotic eyedrops in their newborn baby's eyes. In August 1983, a Pennsyl­vania judge (in a case in which I was privileged to testify as an expert witness) ruled against doctors who were trying to take custody of a leukemic child away from parents who rejected chemotherapy.

This past year, I have had the opportunity to keynote the annual convention of the American Medical Students Association, to testify against thewhooping cough vaccine before the annual convention of the American Medi­cal Association, and to address the American College of Emergency Physicians. Last month, I spoke to medical students at my own University of Illinois Medical School, and next month I will be speaking to medical students at the University of Michigan Medical School. During the past 12 months, I have appeared on more than 200 television and radio programs, and I have given interviews to dozens of newspaper and magazine reporters. The sub­scriptions to my monthly Newsletter have doubled, and my third book, "How to Raise a Healthy Child--In Spite of Your Doctor," should be on the book­shelves in the next few weeks.

Nor am I alone in my efforts to bring the truth about Modern Medicine to public attention. Dozens of books which are critical of "standard" med­ical procedures have recently been published, many of them written by M.D.'s.

On a more personal level, my daughters have given me five grandchildren, all born at home with the help of midwives.

Since your return address indicates that you are connected with probably the largest medical foundation in New Orleans, perhaps your own pessimism stems from associating too closely with those who have not yet seen the light. Make some new friends. Get close to some of the millions of people in this country who agree with you and with me, and see whether your pessi­mism doesn't turn to optimism. As far as I am concerned, it's been a very good decade. And the best is yet to come.

My brother, who is in his fifties, recently was admitted to the hospital for a checkup because of a history of heart palpitations which were be­coming more frequent. After a few days of hospital rest and the usual tests (cardiogram, monitoring, etc.), all of which were o.k., he seemed ready to be released. However, his doctor wanted him to have a "stress test" before going home. Several hours after that test, my brother suf­fered a non-fatal heart attack.

What do you think about giving this test? Isn't such a strenuous test for someone like my brother who is not in the best of shape, against all the normal principles of exercising which are that you should begin slowly and gradually build up your stamina?--A.S.

While the stress test (exercise EKG test) is one of the most popular cardiac tests today, many patients are not aware of its risks. Two or three of every 10,000 persons tested will suffer a heart attack, and one per 10,000 will die from this test which is used in the diagnosis of coronary artery disease and in the measurement of the patient's physical capacity. Because of the risk of collapse, exacerbation of existing heart disease, stroke, and heart attack, all necessary equipment for resuscitation--including cardiac drugs--must be kept right on hand in the exercise EKG laboratory.

6

Questioning PAP test readings

Medical doublespeak

According to world-renowned cardiologist Edward K. Chung, M.D. ("One Heart, One Life," Prentice Hall, $8.95), the possible risks of the stress test should be fully explained to the patient, and the patient should sign an informed consent form before the test is carried out. Since this test is not 100 percent reliable, some patients (as many as 66 percent) who do not have coronary heart disease will show abnormal test results, and others who do have definite coronary artery disease will show normal test results. While the stress test (whether carried out in the old­fashioned way of walking up and down two stairs or on the newer tread­mills) is considered to be a fair predictor of future heart problems by some physicians, many other physicians feel the test has no value ("The Patient's Guide to Medical Tests" by Cathey Pinckney and Edward R. Pinckney, M.D., Facts of File, $7 .95).

Did your brother's doctor tell him the risks as well as the benefits of this test, and was he asked to sign a consent form?

How often have I warned about the inaccuracy of the Pap test? Now, Dr. Hervy E. Averette, professor and director of gynecologic oncology at the University of Miami, echoes these warnings. Quoted in Medical Tri­bune (8/11/83), Dr. Averette warns that the odds are 50-50 that your community pathologist has not been adequately trained to interpret the cervical Pap test. Dr. Averette advises doctors to be aware tha t they may be getting inferior Pap readings as a result of inadequate training of pathologists. Dr. Averette cites a survey of pathologists in which only 55 percent had had any formal training in cytology during their residency. (According to the medical dictionary, cytology refers to "the anatomy, physiology, pathology, and chemistry of the cell .") Forty­three pathologists had never had any formal training, and only 1.6 percent had had specialized training in cytopathology. Makes you wonder what a pathology residency consists of, doesn't it?

The next time your doctor recommends a Pap test, you might ask him about the training of the pathologist who is going to read that smear.

In a scientific article on Barney Clark's artificial hear t (New England Journal of Medicine, February 2, 1984), the surgeons/researchers describe the complications they had predicted would occur. These included destruction of blood elements, infection, endocarditis (inflammation of the lining of the heart), and thrombosis (blood clots). The do c tors took steps which successfully avoided these conditions, and that's the good news. The bad news is that a number of other complications occurred, including hemorrhage from anticoagulant therapy, kidney failure, and pseudomembranous colitis (destruction of the lining of the intestine) after antibiotic therapy was initiated. The anticoagulants were given to avoid thrombosis; the antibiotics were given to avoid infection.

What lesson can we learn from all this? We learn that treatments for prevention carries their own complications which in turn carry their own complications which in turn carry ...

Dr. Mendelsohn's latest book, "How to Raise a Healthy Child in Spite of Your Doctor," has just been published by Contemporary Books ($13.95).

7

The People's Doctor Newsletter

P.O . Box 982 Evanston, Illinois 60204

© Th e People's Doctor Newsletter, Inc .

Publi shed monthly. Subscription rate: $24.00 annually.

RobertS . Mendelsohn, MD, Editor Vera Chatz, Managing Editor

by Marian Tompson Executive Director,

Alternative Birth Crisis Coalition

The following conversation began with a discussion of hypertension (getting this column written had been very much on my mind), but the thoughts of the participants jumped quickly to the question of nuclear war and the possible effects this ever~present worry might be having on our blood pressure and our general health. I had expressed the concern that our global concentration on the possibility of annihilation actually might cause it to become a self-fulfilling prophecy.

"We all feel the crisis," said John. "We ·all see the tlrreat. We're aware of the ugly side of the coin, but as Buckminster Fuller pointed out to me a couple of years ago, it is now time to look at the shiny side. Today, more than 4.5 billion people are living on this planet. That's 4.5 billion people who breathe together and more than four billion hearts that beat together, and we have never before faced a challenge that affects all . So now we have over 4.5 billion solutions to a very complex problem. Every one of us has something to offe~ and we have never before had the opportunity to draw on the potential we have to solve problems. Our present world is rich beyond imagination. All competing systems, including communism and capitalism, have been based on the idea that there isn't enough to go around. It's only in the space age that we know this is false. Space age technology can be shared in a way that doesn't threaten any nation but can feed and clothe and house the people of all nations in a way never before dreamed of.

"We can no longer afford to waste time arguing over who is right and who is wrong ," John continued. "The time has come to step into the un­known and find out what will work. There is no single politic, no single religion and no single organization that can do this job. It is too big. It will take the vision of individuals from all nations and from all religions to find the way. life in order to help each away the battlefield. Our world peace."

We don't have to destroy each other's way of other. Preparations for world war have taken only option now is to make preparations for

"I see these preparations already being made," I interjected, "in parents who defend their right to have their children born into a loving environment, in mothers committed to giving their infants the very best by breastfeeding them, and in the fathers who share in their care. From this kind of dedicated parenting comes my hope for the future. For the result has been a new generation of children who are not only precociously bright but who, being so loved, are loving people themselves. And in this love lies our salvation because there can be no true peace as long as people have hate in their hearts. This love we give to our children and the other people who touch our lives might be our most important contribu­tion to a peaceful world and a golden age."

"Bucky [Fuller] also believed in the potential of the individual and the ripple effect of love," John agreed. "In 'The Critical Pa th,' which he considered his most important book, he pointed out that it will t ake people from all over the world to begin this fearless cooperation. But it can be done . And while there isn't yet a way designed to help bring forth unlimited wealth, we can design one. But one thing is certain. It can't be done by creating another competing system. It can happen only by building bridges of compromise and cooperation among historical competitors."

"All you ' need is love," our teenagers used to sing. And John now says, "We are being forced to ask the final question: How far are we willing to love?"

8